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评价用于复杂下颌骨骨折虚拟复位的内部触觉辅助手术规划。

Evaluation of in-house, haptic assisted surgical planning for virtual reduction of complex mandibular fractures.

机构信息

Oral and Maxillofacial Surgery, Zealand University Hospital, Roskilde, Denmark.

Plastic and Oral and Maxillofacial Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.

出版信息

Int J Comput Assist Radiol Surg. 2021 Jun;16(6):1059-1068. doi: 10.1007/s11548-021-02353-w. Epub 2021 Apr 27.

DOI:10.1007/s11548-021-02353-w
PMID:33905085
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8166680/
Abstract

PURPOSE

The management of complex mandible fractures, i.e. severely comminuted or fractures of edentulous/atrophic mandibles, can be challenging. This is due to the three-dimensional loss of bone, which limits the possibility for accurate anatomic reduction. Virtual surgery planning (VSP) can provide improved accuracy and shorter operating times, but is often not employed for trauma cases because of time constraints and complex user interfaces limited to two-dimensional interaction with three-dimensional data.

METHODS

In this study, we evaluate the accuracy, precision, and time efficiency of the haptic assisted surgery planning system (HASP), an in-house VSP system that supports stereo graphics, six degrees-of-freedom input, and haptics to improve the surgical planning. Three operators performed planning in HASP on computed tomography (CT) and cone beam computed tomography (CBCT) images of a plastic skull model and on twelve retrospective cases with complex mandible fractures.

RESULTS

The results show an accuracy and reproducibility of less than 2 mm when using HASP for virtual fracture reduction, with an average planning time of 15 min including time for segmentation in the software BoneSplit.

CONCLUSION

This study presents an in-house haptic assisted planning tool for cranio-maxillofacial surgery with high usability that can be used for preoperative planning and evaluation of complex mandible fractures.

摘要

目的

复杂下颌骨骨折的治疗，即严重粉碎性骨折或无牙/萎缩性下颌骨骨折，具有一定挑战性。这是由于三维骨丢失，限制了准确解剖复位的可能性。虚拟手术规划（VSP）可以提供更高的准确性和更短的手术时间，但由于时间限制和仅限于二维与三维数据交互的复杂用户界面，通常不适用于创伤病例。

方法

在这项研究中，我们评估了触觉辅助手术规划系统（HASP）的准确性、精度和时间效率，该系统是一个内部的 VSP 系统，支持立体图形、六自由度输入和触觉，以改善手术规划。三名操作人员在塑料颅骨模型的计算机断层扫描（CT）和锥形束计算机断层扫描（CBCT）图像上以及 12 例复杂下颌骨骨折的回顾性病例上使用 HASP 进行了规划。

结果

研究结果表明，使用 HASP 进行虚拟骨折复位时的准确性和可重复性小于 2 毫米，平均规划时间为 15 分钟，包括软件 BoneSplit 中的分割时间。

结论

本研究提出了一种用于颅颌面外科的内部触觉辅助规划工具，具有较高的可用性，可用于术前规划和评估复杂的下颌骨骨折。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6da4/8166680/29cb6286bbf0/11548_2021_2353_Fig10_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6da4/8166680/68b4fa92de50/11548_2021_2353_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6da4/8166680/14faee715e16/11548_2021_2353_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6da4/8166680/bf6adcebeec9/11548_2021_2353_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6da4/8166680/32005b4c08b6/11548_2021_2353_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6da4/8166680/387c4b729561/11548_2021_2353_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6da4/8166680/0fb010268db5/11548_2021_2353_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6da4/8166680/c587f086cd9c/11548_2021_2353_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6da4/8166680/29cb6286bbf0/11548_2021_2353_Fig10_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6da4/8166680/68b4fa92de50/11548_2021_2353_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6da4/8166680/3f27bc059b0b/11548_2021_2353_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6da4/8166680/0083d276fe28/11548_2021_2353_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6da4/8166680/14faee715e16/11548_2021_2353_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6da4/8166680/bf6adcebeec9/11548_2021_2353_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6da4/8166680/32005b4c08b6/11548_2021_2353_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6da4/8166680/387c4b729561/11548_2021_2353_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6da4/8166680/0fb010268db5/11548_2021_2353_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6da4/8166680/c587f086cd9c/11548_2021_2353_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6da4/8166680/29cb6286bbf0/11548_2021_2353_Fig10_HTML.jpg

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